# Fiscal space for the immunisation program in Zambia– an efficiency analysis approach

## TL;DR

This study assesses the efficiency of Zambia's immunisation program and finds that improving efficiency could save enough vaccines to cover additional districts.

## Contribution

The study uses Data Envelopment Analysis to quantify technical efficiency and estimate fiscal space for immunisation in Zambia.

## Key findings

- 38% of the 24 sampled districts were technically inefficient in immunisation services.
- Improving efficiency could save enough vaccines to supply 5 to 14 additional districts.
- The average efficiency score was high at 0.92 (CRS) and 0.95 (VRS).

## Abstract

The immunisation programme in Zambia remains one of the most effective public health programmes. Its financial sustainability is, however, uncertain. Using administrative data on immunisation coverage rate, vaccine utilisation, the number of health facilities and human resources, expenditure on health promotion, and the provision of outreach services from 24 districts, we used Data Envelopment Analysis to determine the level of technical efficiency in the provision of immunisation services. Based on our calculated levels of technical efficiency, we determined the available fiscal space for immunisation.

Out of the 24 districts in our sample, 9 (38%) were technically inefficient in the provision of immunisation services. The average efficiency score, however, was quite high, at 0.92 (CRS technology) and 0.95 (VRS technology). Based on the calculated level of technical efficiency, we estimated that an improvement in technical efficiency can save enough vaccine doses to supply between 5 and 14 additional districts. The challenge, however, lies in identifying and correcting for the sources of technical inefficiency.

The online version contains supplementary material available at 10.1186/s13104-024-06696-w.